EMQ'S of MRCOG 1

Hi to all!
i'm resiting for MRCOG1 in March 2012 Inshala.i've appeared before but can't get through by1.5% in paper 1 n 1% in paper 2.my trouble is with EMQ's.
this forum is very helpful.plz all preparing for MRCOG 1 out there help me to answer these EMQ's.special request to mandible n dr sumia n plz add more EMQ pool as MCQ's are mostly repeated from the past papers but the EMQ' s r new n difficult to solve
Thank You
.Important EMQ for part 1MRCOG
(1) a) ant division of ant. remi of S2-4
b) ant division of post.rami of S2-4
b)genitofemoral nerve
c) post division of ant. remi of S2-4
d) post division of post. remi of S2-4
e) sensory supply of perineal nerve
f) inferior rectal nerve
g) ischial tuberosity
h)ischial spine
A lady is about to deliver and you are about to give her a pudendal block..
Q1- what is the root value of pudendal nerve?
Q2- what nerve supplies lower part of vagina (I think)?
Q3- why do u give local skin infiltration before episiotomy?
Q4- or what is the nerve supply of peranal area .?

(2).. If we take the day of fertilization as Day’0’ then…
Day2
Day4
Day 8
Day 10
Day12
Day 14
Day 18
Day20
Day 22
Day 24
Day 26
Day 42 [
Day 70
Q1- Which represents 4 cell stage ?
Q2- conceptus implants completely?
Q3- fetal heart pulse seen on ultrasound?
Q4- vertebra form completely?

(3) A Cytoplasmic transcription factor receptor
B G protein coupled receptor on cell membrane
C G protein coupled receptor on Golgi complex
D Mega subunit ligand gated ion channel
E Multisubunit antibody receptor on cell membrane
F Multisubunit ligand gated ion channel on cell membrane
G Nuclear protein kinase receptor
H Nuclear transcription factor receptor
I Protein kinase receptor on cell membrane
J Receptor protein complex (intracytoplasmic)
K Transcription factor receptor on cell membrane
Select the receptor which binds the molecules referred to in the itemS below. Each option may be used once, more than once or not at all.
1- insulin .
2- progesterone .
3- ostradiol .
4- prostaglandin .

(4) PCR
Fish test
Chromosomal linkage analysis
Telomer analysis
Sum hereditary crosslinkage chromosomal option (dnt remember)
Screen for some known gene mutation
Sweat test
Saliva test
-A family with one kid presumed to have cystic fibrosis however cftr gene mutation was not detected. Family members willing to give samples if needed.mother wants definite diagnosis as she is 11wks and wants to know diagnosis for her baby.parents are cousins with 1st degree relatives having cystic fibrosis.
1- Invasive diagnostics can be applied to reach final results by?
2- you have Guthrie spot of their son how will u diagnose him for cystic fibrosis?
3- families in UK with cystic fibrosis how will u find f508?

(5) A- Endoplasmic reticulum
B- Golgi apparatus
C- Lysosomes
D- Microtubules
E- Mitochondria
F- Nucleolus
G- Plasma membrane
H- Ribosomes
Select the most appropriate organelle that matches the following descriptions
1- Contains enzymes capable of digesting cells and cellular material
2- 'Reads' the mRNA and builds protein .
3- Modification of lipids and proteins with storage of material prior to export out of the cell.

(6) screening test for following
1- syphilis treponemal antibody test
2- syphilis hemaglutination test
3- syphilis immobilization test
4- HB-electrophorisis
5- mcv
6- mchc
7- MCh
8- serum iron
9- paul-bennel test

A- alpha thalessemia
B- folic acid deficiency
C- iron deficiency anemia
D- primary syphilis in early untreated period

(7) on taking a large protein meal?
A- Decrease decrease
B- Increase increase
C- Increase decrease
D- Deacrease increase
E- Nochange no change
F- Nochange increase
G- Nochange decrease
Insulin & Glucagon excretion what will happened ...?

( a- 3-hydroxyisovaleric acid .
b- 17-alpha hydroxyprogesterone .
c- 17-delta hydroxyprogesterone .
d- acetic acid .
e- cortisol .
The following level of certain metabolities in amniotic fluid changes significantly of the fetus has an inborn error of the metabolism .select the single metabolite from list of the options above whose level in amniotic fluid is altered by inheretiance disease in item below.
congentiat adrenal hyperplasia

(9) A- Adrenaline
B- Calcitonin
C Cholecystokinin
D- Cortisol
E- Glucagon
F- Insulin
G- Progesterone
H- Somatostatin
IT- estosterone
Select the appropriate hormone from the list for the following structures that produce it. Each answer may be used once, more than once, or not at all.
1- Adrenal Cortex .
2- Adrenal Medulla .
3- Pancreatic alpha cell .
4- Pancreatic D Cells .

(10) AAnterior cerebral artery
BAnterior communicating artery
CAnterior inferior cerebellar artery
DBasilar artery
EInternal auditory artery
FInternal carotid artery
GMiddle cerebral artery
HPosterior cerebral artery
IPosterior communicating artery
JSuperior cerebellar artery
KVertebral artery
Complete the diagram of the circle of Willis using the options given:
this question came with diagrame in september 2007
so you should study circle of weils very well if I get the pictures I will post it .

11.Akeratinising stratified squamous epithelium
Bnon-keratinising stratified squamous epithelium
Cpseudostratified columnar epithelium
Dsimple columnar epithelium
Esimple cuboidal epithelium
Ftransitional epithelium
Which of the epithelial types described above are present in the anatomical regions below:
1- ectocervix .
2- endocervical canal .
3- cervical ectropion .
4- transformation zone of cervix .
5- vagina .
6- uterus .
7- Bladder .
8- Trachea .
9- Labia Majora .
10- Bowel .
11-Fallopian tube .
12- Vulva .
13- anal canal .

12.A- Autosomal co-dominant
B- Autosomal dominant
C- Autosomal recessive
D- Polygenic
E- Single gene defect
F- X linked dominant
G- X linked recessive
[Select the most likely mode of inheritance for the following patients’ conditions:
1- A 27 -year old female developed gestational diabetes mellitus. Her uncle and grandmother also had diabetes mellitus2- A mothr is concerned regarding her baby who has developed fractures which appear to occur with minimal trauma. He has blue sclera.
3- An 18-year old female underwent caries tooth extraction and developed profuse bleeding. On history she revealed menorrhagia. Her mother and her grandfather had the same disease.

13.A- WARFARIN .
B- HEPARIN .
C- AMPICILLIN .
D- METHYLDOPA .
E- PENCILLIN .
F- CARBIMAZEPINE .
G- METRONIDAZOLE .
H- NON OF THE ABOVE .
I- ALL OF THE ABOVE .
For each of the following choose the single most appropirate statement from the above list of options .
1- Drug contraindicated in breast feeding .
2- Drug does not cross the placenta .

14.A. Calcitonin
B. Cortisol
C. Glucagon
D. Growth hormone
E. Insulin
F. Oestradiol 17-¦Â¦Â
G. Oxytocin
H. Parathyroid hormone
I. Prolactin
J. Thyroxine
Instructions: For each action described below, choose the single most likely causative hormone from the above list of options. Each option may be used once, more than once, or not at all.
Question 3: Stimulates deposition of cartilage at the ends of bones
Question 4: Raises blood glucose levels through the breakdown of fat and protein
Question 5: Antagonises the effect of parathyroid hormone to minimise bone density loss
Question 6: Stimulates the release of milk from the breast
Question 7: Stimulates the urinary secretion of calcium

15.Options
A. Common iliac artery
B. External iliac artery
C. Inferior epigastric artery
D. Inferior vesical artery
E. Internal iliac artery
F. Middle rectal artery
G. Ovarian artery
H. Superior vesical artery
I. Umbilical artery
J. Uterine artery
K. Vaginal artery
Instructions: After a forceps delivery a 30-year-old primigravida sustains a primary post partum haemorrhage of four litres. Although the uterus appears well contracted the bleeding continues, and a decision is made to identify and treat the bleeding point radiologically. For each question posed below, choose the single most appropriate option from the above list. Each option may be used once, more than once or not at all.
Question 8: What vessel runs up the broad ligament?
Question 9: Which other vessel arises from the uterine artery?
Question 10: Which other vessel anastomoses with the uterine artery? Question 11: Which vessel does the uterine artery arise from?
Question 12: Which vessel runs anterior and superior to the ureter?

16.Options :
A- vitamin A
B- vitamin E
C- vitamin D
D- vitamin B12
E- vitamin B6
F- vitamin C
G- folic acid
H- riblflavine
I- vitamin K
J- thiamine
1- fat soluble vitamin sysnthesised in the intestinal wall from the beta carotene .
2- fat soluble vitamin synthesised by large intestinal bacteria .
3- deficiency of this vitamin in childhood causes rickets .
4- fat soluble vitamin synthesis by the kidney is regulated by parathyroid hormone .
5- deficiency of this vitamins typicaly occurs in women with hyperemesis gravidarum .
6- water soluble vitamin with anti-oxidant effects .
7- absorption of this vitamin requires the presence of intrinsic factor .
8- deficiency of this vitamin causes megaloblastic anaemia and neurological disorders .
9- fat soluble vitamin produced in the skin by photo-activiation of 7- dehydrocholesterol .
10- fat soluble vitamin with anti-oxdant effects .
11- fat soluble vitamin deficiency associated with raised serum alkaline phosphatase .
12- deficiency of this vitamin associated with osteomalasia .
13- maternal intake of this vitamin around the time of coception has been shown to reduce incidance of neural tube defects .
14- fat soluble vitamin , deficiency occur within few a days of cessation of bile secretion .
15- this vitamin is a cofactor in synthesis of prothrombin .

17.A.Candida spp
B- Herpes simplex virus
C- Human immunodeficiency virus
D- Gardnerella vaginalis
E- Chlamydia trachomatis
F- Human papilloma virus
G- Treponema pallidum
H- Neisseria gonorrhoeae
I- Trichomonas vaginalis
Select the micro-organism described in the following cases:
1- An obligate intracellular gram negative bacterium ....
2- The cause of lymphogranuloma venereum .........
3- Neutrophils containing gram negative diplococci .....

18.A.Double Y Syndrome
B- Down’s Syndrome
C- Edward’s Syndrome
D- Fragile X Syndrome
E- Klinefelter’s Syndrome
F- Patau’s Syndrome
G- Turner’s Syndrome
Please select the most appropriate syndrome from the options below. You may use each option once, more than once, or not at all.
1- An infant girl is born with a webbed neck, hypertension and audible ejection systolic murmur.
2- A neonate boy is born with cleft lip and palate, low set ears and polydactyly. The child survives for only 3 weeks.
3- An infant boy is born with hypotonia, epicanthic folds and single palmer creases.

19.A.Adrenal arteries
B- Celiac trunk
C- Common iliac arteries
D- Gonadal (ovarian or testicular) arteries
E- Inferior mesenteric artery
F- Lumbar arteries
G- Median sacral artery
H- Renal arteries
I- Superior mesenteric artery
Select the most appropriate option:
1- Gives rise to the left gastric, splenic and hepatic arteries.
2- Gives rise to the intestinal, middle colic and right colic arteries.
3- Gives rise to the left colic, sigmoid and superior rectal arteries.
4- An unpaired branch that arises from the aortic bifurcation.
5- Arises from the aorta between the level of L1 and L2 vertebrae, and forms five segmental arteries that do not anastomose.
20.A- Candida spp
B- Chlamydia trachomatis
C- Herpes simplex virus
D- Human immunodeficiency virus
E- Gardnerella vaginalis
F- Human papilloma virus
G- Neisseria gonorrhoeae
H- Treponema pallidum
I- Trichomonas vaginalis
Select the micro-organism described in the following cases:
1- A thin motile, gram negative spiral shaped bacterium ...
2- An anaerobic flagellated protozoan ...
3- A single strand RNA virus ..

21.A.ACTH
B- CRH
C- Dopamine
D- FSH
E- GnRH
F- Growth Hormone
G- LH
H- Prolactin
I- Somatostatin
J- TSH
Please select the correct hormone from the options for each of the descriptions below. You may use each option once, more than once, or not at all.
1- This hormone acts on cartilage and liver to release IGF-1...
2- This hormone promotes iodination of tyrosine residues...
3- This hypothalamic hormone inhibits the secretion of growth hormone...
4- In males, this hormone facilitates the generation spermatozoa...
5- This hormone inhibits galactorrhea

22.A.Deep inguinal
B- Inferior mesenteric
C- Internal iliac
D- Para-aortic
E- Superficial inguinal
Lymph from the following structures passes to the above group of lymph nodes first. Please choose the most appropriate answer from the list above.
1- Rectal .
2- Vulva .
3- Hallux .
4- Cervix .
5- Upper anal canal .

23.A.Bias
B- Correlation
C- Error
D- False positive
E- False negative
F- Null hypothesis
G- Power
H- Regression
I- Sensitivity
J- Specificity
Which of the above statistical terms is described by the following statements:
1- A random source of inaccuracy...
2- A type 2 error...
3- Ability to exclude a true negative...

24.A.Clostridium perfringens
B- clostridium difficile
C- Escherichia coli
D- Haemophilus influenzae
E- Staphylococcus aureus
F- streptococcus pyogenes
G- none of the above
Select the most likely causative organism for the following infections.
1- Chronic osteomyelotis after implant surgery ..
2- Gas gangrene ..
3- Pseudomembranous colitis ..

25.A.Mean
B- Median
C- Mid-range
D- Mode
E- Range
F- Spread
G- Standard Deviation
H- Standard Error
Select the appropriate term from the list for the following definitions. Each answer may be used once, more than once, or not at all.
1- Most frequent value ..
2- Spread of estimates of sample means around the true population mean .
3- The measure of spread of values around the mean .
4- The mid value when all values are listed in ascending order .
5- The sum of all the values divided by the number of values

26.A.endothelial growth factor
B- human chorionic gonadotrophin
C- human placental lactogen
D- IGF-1
E- Insulin
F- leptin
G- oestrogen
H- progesterone
I- relaxin
Select the most appropriate hormone for the following statements.
1- The hormone that is the basis of most pregnancy tests.
2- Hormone produced by synctiotrophoblast to regulate nutrient storage in the final stages of pregnancy.
3- Hormone that is secreted by decidual cells of the placenta .
4- The hormone that is lactogenic, regulates glucose metabolism and promotes fat breakdown .

27.For the pregnancies at risk of the following conditions (1- , select the most appropriate prenatat diagnostic investigation from the alternatives (a-e).
conditions:
----------------
1- spina bifida.
2- duchenne muscular dystrophy.
3- cystic fibrosis.
4- congenital heart disease.
5- sever osteogenesis imperfecta.
6- fetal rubella .
7- anonychia .
8- down syndrome
Alternatives:
--------------------
a- karyotyping of the fetal amniocytes .
b- fetoscopy .
c- DNA analysis of chorionvillus sample .
d- ultrasonography .
e- fetal blood sampling .

28Which of the following viruses are associated with the following conditions
1- Herpes simplex type 2 .
2- Human papillomavirus types 16 and 18 .
3- Hepatitis E .
4- Echoviruses .
5- Cytomegalovirus .
a- cervical intraepithelial neoplasis (CIN) .
b- severe and often fatal maternal infection in pregnancy in developing counteries .
c- outbreaks of infection in nurseries for newborn infants .
d- neonatal infection acquired via fetal scalp monitoring .
e- persistent and generalised fetal infection .

29.For each complication (a-d) select the drug (i-v) most likely to be the cause :
a- Cystitis .
b- Cardiac toxicity .
c- Pulmonary fibrosis .
d- renal toxicity .[/i]
[i]i- Vincristine .
ii- Bleomycin .
iii- cis platinum .
iv- Cyclophosphamide .
v- Doxorubicin .

30.For each drug (A-B) select the appropriate description(i-v):
A- 5-Fluorouracil (5FU) .
B- Cyclophosphamide .
i- Pyridine of purine analogue .
ii- Alkylating agent .
iii- Folic acid analogue .
iv- Plant alkaloid .
v- Antibiotic .

31Match the following (A - E) to five of the statements below..
DURING THE MENSTRUAL CYCLE ;
A- follicle stimulating hormone .
B- oestradiol .
C- progesterone .
D- the first meitotic division .
1- is completed following the LH surge .
2- is produced by the adrenal gland .
3- is completed during the neonatal period .
4- is inhibited by oestradiol .
5- decereases mid - cycle .
6- is a precursor of oestradiol .
7- is inhibited by GnRH .
8- is produced throughout the cycle .
9- is produced in the secretory phase .
10- is secreted by the hypthalamus.

32Match five of the following hormones / steriods to the statements below :
a- Dihydroepiandrostenedione .
b- FSH .
c- GnRH .
d- Insulin .
e- LH .
f- Oestradiol .
g- Progesterone .
h- Prolactin .
I- Testosterone .
j- Thyroid stimulating hormone (TSH) .
1- is produced in a pulsatile fashion from the hypothalamus .
2- is increased in the postpartum period .
3- is produced predominantly by the thecal cells in women .
4- is the pituitary hormone that is stimulated by low oestradiol concentrations .
5- is produced predominantly by the adrenal gland in women